Slide 1Chief, Aging and Disability Services
Description + Target Audience Description
This class will provide clinicians and other human service staff with a better understanding of how the County serves older people and people with disabilities. Participants will learn about the overall mission of Aging and Disability (A&D) Services, and the programs offered by the three major areas that comprise A&D. In addition, we will discuss how services to this population are integrated within the Department, and how participants can apply this information to their own practice and client referrals. In addition to PowerPoint presentations, attendees will have the opportunity to interact with presenters as a panel, and participate in group discussions.
Target Audience
Clinicians, social workers, healthcare and human service workers serving this population, and those seeking a better understanding of programs provided across the Montgomery County Department of Health and Human Services.
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Discuss current issues affecting the aging population and those with disabilities in Montgomery County.
Understand the role of A&D to ensure the safety and well- being of this population.
Summarize services provided by Assessment and Continuing Case Management; Area Agency on Aging; and Disability Services Community Service Network.
Name three ways this information can be applied to your work and clinical practice.
Identify opportunities to collaborate with Aging and Disability Services to provide better client outcomes.
Name three community partners who provide A&D program services.
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Aging and Disability Services Mission and HHS Guiding Principles Adopted: March 2, 2004; updated September 11, 2017
Aging and Disability Services Mission: Advancing a safe and inclusive community with opportunities for individuals to live well, achieve their potential, and thrive.
HHS Guiding Principles: • We will provide services that build on the strengths of our customers and
the community. • We will be responsive to the changing needs of our community. • We will recruit and maintain competent, customer service oriented staff. • We will make operational a “no wrong door” approach to services delivery. • We are committed to the highest quality customer service for all those
seeking services, and hold our staff accountable to demonstrate respect, professionalism, timeliness and fairness.
• We value the skill and dedication of our staff and will provide them with adequate support, resources and training to serve our customers well.
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Aging and Disability Commissions and Advisory Groups
• Commissions • Commission on Aging • Commission on Veteran’s Affairs • Commission on People with Disabilities
• Advisory Groups • Age-Friendly Montgomery • Dementia-Friendly Montgomery • Adult Public Guardianship Review Board
Regulatory and Funding Connection to State Departments
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Dept. of Education
DEPARTMENT HEALTH AND HUMAN SERVICES (DHHS) / AGING AND DISABILITY SERVICES (A&D) Point of Entry for Aging and Disability Resource Unit (ADRU) 240-777-3000 (Voice) 240-777-4575 (TTY) 240-777-1495 (FAX)
Mobility and Transportation Mgr.
Shawn Brennan Comm. Outreach
Community Outreach Manager
Mrg. Gr. 28
Comm. Outreach Mrg. Gr. 28 1 Admin. Specialist Gr. 18
Dr. Odile Brunetto 1 Service Area Chief
MLS M1 1 Program Manager II Gr. 25
1 Executive Admin. Aide Gr. 17
Raymond L. Crowel, Director
DISABILITIES SERVICES | COMMUNITY SUPPORT NETWORK (CSN)
Kim Mayo, MLS Mgr. 2 1 Admin. Specialist II Gr. 21
1 Admin. Special I Gr. 18Adult Public Guardianship Review Board
Fiona Graham, 1 Supervisory Social Worker (SSW) Gr.26
Adult Services Intake (ASI) Virginia Beckett, SSW Gr. 26
5.5 SWIII Gr. 24 1 SWII Gr. 23
1 Program Specialist II Gr. 21 1 Principal Admin Aide Gr. 13
Adult Protective Svcs. (APS) #1 Denise Bruskin-Gambrell
1 SSW Gr. 26 7 SWIII Gr. 24
1 Comm Health Nurse (CHN) Gr 24 0.5 Office Services Coor. Gr 16
APS #2 Julia McGlamary 1 SWIV Gr. 26
8 SWIII Gr. 24 0.5 Office Services Coor. Gr 16
Guardianship/APS Fiona Graham, 1 SWIV Gr. 26
8 SWIII Gr. 24 1 CHN Gr 24
0.5 Office Services Coor. Gr 16
Social Services to Adults (SSTA) Marsha Aaron 1 SWIV Gr. 26
6 SWIII Gr. 24 2 Sr. Care SW III Gr. 24
1 Office Services Coor. Gr. 16
Senior Community Programs David Salem, 1 MLS Mgr. 3
1 Office Service Coordinator Gr. 16
A&D Resource Unit (ADRU) Jennifer Long 1 Prog. Mgr. Gr 23
8 Client Asst. Spec. Gr. 20
Senior Nutrition Program Carol A Craig, 1 Prog Mgr. II Gr. 25
Vacant, 1 PM I Gr. 23 1 Office Serv. Coord. Gr. 16
0.5 Office Services Coor. Gr. 16
AAA Budget and Contracts Lisa Yang, 1 PM II Gr. 25
Senior Group Home Subsidy Lisa Peet, 0.5 Prog. Mgr. I Gr. 23
Villages Coordinator Pazit Aviv, 1 Program
Manager. II Gr. 25
Community First Choice (CFC)/Support Planning
Peter Flandrau, PM II Gr. 26 4 Prog. Specialist II Gr. 21
4 Contract Staff 1 Office Services Coor. Gr. 16
AREA AGENCY ON AGING (AAA) SENIOR COMMUNITY SERVICES Dr. Patrice McGhee, Director, 1 MLS Mgr. 2
1 Office Services Coordinator Gr. 16
Adult Evaluation & Review Services (AERS) #1
Tonia Powell 1 Nurse Mgr. II Gr. 25 8 CHNII Gr 24
1 FT Contract Nurse 1 Contract. Program Specialist
O.5 Office Services Coord. Gr. 16
AERS #2 Donna Klein 1 Nurse Mgr. II Gr.25
8 CHN II Gr 24 2 PT Contract Nurses
1 Contract Program Specialist O.5 OSC Gr. 16
Long-Term Care Ombudsman Eileen Bennett, 1 PM II Gr. 25
4.5 Prog. Mgr. I Gr. 23 1 SWIII Gr. 24
1 Office Services Coor. Gr. 16
Assistant Administrator Dr. Kimberly Johnson
1 MLS Mgr. 3 1 Program Manager (PM) I Gr. 23
1 Administrative Specialist II Gr. 21
Adult Foster Care (AFC) and Project Home
Karen Ellis 1 SSW Gr. 26 5 SWIII Gr. 24
1 Office Services Coor. Gr. 16
Home Care Services Merit Personal Care Case Mgt Contract Dr. Kimberly Johnson
1 SSW Gr. 26 1 CHN II Gr. 24
7 Comm. Serv. Aides III Gr. 18
Home Care Services Contract Supervisor
Nina Chaiklin 1 SSW Gr. 26 1 Program Specialist II Gr. 21
1 Prin. Administrative Aide Gr. 13 Self Employed Providers
Senior Care and Adult Day Care 1 Sr. Care SW III Gr. 24
.75 Sr. Care Fiscal Asst. Gr. 16
ASSESSMENT AND CONTINUING CARE MANAGEMENT Mario Wawrzusin, 1 MLS Mgr. 2
0.5 Office Services Coordinator (OSC) Gr. 16
CFC/Nurse Monitoring Chris Shao, Nurse Mgr. Gr. 25
Stella Akuchie, Nurse, Mgr. Gr. 25 2 Billing Specialist Gr. 21
1 PAA Gr. 13
Health Promotion Program Tina Purser Langley, 1 PM II Gr 25
AAA Data and Evaluation Mrg. Dr. Erin Smith, 1 PM I Gr. 23
Caregiver Supports Lylie Fisher, 1 PM II Gr. 25
Senior Fellow-Age Friendly MC
My Turn Prog. | Contracts for People w-Disabilities
Eldora Taylor 1 PM II Gr. 24 2 Program Specialist II Gr. 21
1 Office Clerk
Coordination of Community Svcs. Rosemary DiPietro 1 PM I Gr. 23
1 Quality Assurance Lead Wkr. 10 Prog. Spec. II Gr. 21
1 Office Services Coordinator 2.5 Contractor
Autism Waiver Karen Gipson, 1 PM Gr. 23
6 Program Specialist II Gr. 21 1 Contract Staff
Group Home Site Visits and Contracts
1 Program Specialist II Gr. 21
Customized Employment 29 Interns, Gr. 1
Sign Language Services
Betsy Tolbert Luecking Comm. Outreach Mrg. Gr. 28
1 Admin. Specialist Gr. 18
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FY19 A&D Distribution of Funding (by Population Served)
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54%
46%
59 and under 60+
Projected growth in Montgomery County’s Older Population
By 2040, nearly 60% of 55+ adults will be part of a minority group
Source: Census ACS 2009-13
Total White Alone Total All Other
34% 57%
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Disability Types and Rates in Montgomery County Based on 2017 American Community Survey Supplemental Estimates
24,641
14,259
30,645
41,325
17,340
32,958
With a hearing difficulty
With a vision difficulty
With a cognitive difficulty
With an ambulatory difficulty
With a self-care difficulty
Montgomery County Residents
66% 13%
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9%
91%
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Ethnic/Racial Minority Seniors More Likely to Have Inadequate Income Annual Household Income Below $25,000 American Community Survey, 2016
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Hispanic Asian Indo-European
2016 American Community Survey: 65+ who speak English “not well” to “not at all”
Limited English Proficiency High Among Ethnic Older Adults
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Adult Services Intake Unit
Senior Information and Assistance
AERS Evaluations
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Adult Evaluation and Review Services (AERS)
Statewide Evaluation and Planning Services (STEPS)
Senior Care
Assess for
Senior Group Homes
https://youtu.be/6LM1aRMbduw
Vulnerable Adults
18 years and older
Lacks the physical or mental capacity to provide for their daily needs
Unable to make and/or implement a plan of care
Unable to remove self from dangerous situation
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Adult Protective Services (APS)
What is Elder/Vulnerable Adult Abuse?
In general, elder/vulnerable adult abuse refers to intentional or neglectful acts by a caregiver or “trusted” individual that lead to, or may lead to, harm of a vulnerable adult.
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Presentation Notes
Administration on Aging (AoA) National Adult Maltreatment Reporting System (NAMRS) The National Adult Maltreatment Reporting System (NAMRS) will be the first comprehensive, national reporting system for APS programs. NAMRS will collect quantitative and qualitative data on the practices and policies of adult protective services (APS) agencies and the outcomes of investigations into the maltreatment of older adults and adults with disabilities. The absence of data for research and best practice development has been cited by numerous entities, including the Government Accountability Office, as a significant barrier to improving APS programs. Policy makers, APS programs, and researchers will use the data to evaluate and improve programs. Keep in mind APS is not just elder abuse, but the majority of our cases do seem to fall in that category. 1 in 44 for financial abuse The goal of NAMRS is to provide consistent, accurate national data on the exploitation and abuse of older adults and adults with disabilities, as reported to APS agencies. Numbers on maltreatment Use the Under the Radar Stats “NAMRS”https://aoa.acl.gov/AoA_Programs/Elder_Rights/NAMRS/index.aspxNAMRS is an annual, voluntary system to collect both summary and de-identified case-level data on APS investigations.
SELF-NEGLECT: is the inability of a vulnerable adult to provide for his/her physical or mental health and well- being;
Indicators:
Individual losing weight
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Exploitation: any action which involves the misuse of a vulnerable adult’s funds, property or person
Indicators: Unusual banking activity Lack of amenities victim could afford Missing checks, credit cards, and or belongings Changes in purchasing pattern Newly authorized P.O.A., transfer of property Caregivers has control of vulnerable adults money,
but is failing to provide for their needs 24
NEGLECT: Is the willful deprivation of a vulnerable adult from adequate food, clothing, medical treatment, shelter, or supervision
Indicators:
Vulnerable adult losing weight
Person with dementia left unsupervised 25
ABUSE: Sustaining of any physical injury by a vulnerable adult as a result of cruel or inhumane treatment or as a result of a malicious act by a person
Indicators:
Strangulation
Fractures
Burns
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Report Your Concerns to: 240-777-3000 (Mandated reporters are police, health practitioners, or human service workers)
Include in your report to APS: • Name, age, location/address of victim • Describe what you observed • Who was involved • Who can APS contact to learn more • APS reporters remain anonymous unless
specified otherwise
PRINCIPLES
Adults have the right to be safe. Adults retain all their civil and constitutional
rights unless a court adjudicates otherwise. Adults have the right to make decisions that do
not conform with societal norms as long as these decisions do not harm others.
Adults have the right to accept or refuse services.
Presenter
WHAT APS CAN DO?
Examine all aspects of reported maltreatment Collaborate with client (+ family as appropriate)
to maintain their independence, in the least restrictive environment.
• Develop a case plan
• Arrange in-home services
MONTGOMERY COUNTY ELDER/VULNERABLE ADULT ABUSE TASK FORCE
WHAT APS CANNOT DO
APS CANNOT force services on a person who has capacity to consent.
APS CANNOT involuntarily remove someone from their home.
APS CANNOT provide services for which there are no available resources.
APS CANNOT enforce the law. APS CANNOT reveal identity of reporter.
Presenter
Presentation Notes
States can input state Specific info here Anything else we should add here as a national standard? RESEARCH laws about reporters or states should remove if not applicable.
CAPACITY TO CONSENT
Can the client understand relevant information?
• Do you know that you have a serious cut on your leg?
What is the quality of the client’s thinking process?
• How can you get treatment for your wound? Is the client able to demonstrate and communicate a
choice?
Does the client appreciate the nature of his/her own situation?
• What will happen if you don’t get your wound treated?
Presenter
Presentation Notes
https://theacademy.sdsu.edu/wp-content/uploads/2015/06/assessing-client-capacity-trainers-manual-rev-2015.pdf Incapacity is not easily determined. The assessment is influenced by both the experience of the interviewer as well as the tests that are used. Age, eccentricity, poverty or medical diagnosis ALONE do not justify a finding of incapacity. Measurement of decisional capacity happens only at a specific point in time. It is influenced by medical conditions such as: • medication and medication interactions • sensory deficits • substance abuse • mental illness Assessments are also influenced by situational factors such as: • substance abuse, • depression, • social setting, • nutrition Physicians, lawyers, social workers and judges all struggle with the concept. There is no gold standard for determining incapacity. Here are four basic questions to consider when assessing a client’s capacity to make informed decisions 1. Can the client understand relevant information? • Do you know that you have a serious cut on your leg? 2. What is the quality of the client’s thinking process? • How can you get treatment for your wound? 3. Is the client able to demonstrate and communicate a choice? • Do you want to get treatment for your wound? 4. Does the client appreciate the nature of his/her own situation? • What will happen if you don’t get your wound treated? ASK: For this last component what did you mean when you were trying to determine if the client “appreciates” the nature of his/her own situation? The word “appreciate” is a legal term. These four components come from statutes developed across the country. The meaning of “appreciate” is therefore defined by the laws in your state. It can mean: • have understanding • an emotional response • generally understand risks and benefits • understand his/her own situation When “appreciate” is not defined in a statute, it generally means “understanding.” However, “appreciate” has had many, different definitions depending not only on statutes but also on the specific attorney’s and courtroom’s usage. Therefore it is important to get this clearly defined with your legal advisors. Then you need to make your definition explicit when working with others.
MYTHS AND FACTS
Myth #1: Referrals to APS usually result in nursing home placement.
• Fact: APS focuses on the least restrictive intervention possible. Whenever, possible services are provided in the victim’s home.
Presenter
Presentation Notes
Only those cases which have deteriorated to the point of requiring 24-hour medical supervision are referred for nursing home placement. There may also be cases where an adult requests assistance for admission into a facility.
Competency
Ability to make and communicate informed decisions regarding ones finances and/or health care
Requires
Two certificates, by a physician, psychologist or clinical social worker
Decided in a court of law
Enforceability 34
GUARDIANSHIP: Court determination that a person with severe disabilities requires a medical /property decision maker
The State’s Attorney’s Office Law Enforcement (Family Crimes Unit) Department of Aging Department of Health Licensure and Regulatory Services Office of Health Care Quality Attorney General’s Office County Attorney’s Office Housing Code Enforcement Animal Control Local hospitals, home health agencies, private for profit/not for
profit agencies, faith communities
What other agencies work with Adult Protective Services?
Social Services to Adults Provides assessment and case management to vulnerable adults so as to prevent unnecessary institutionalization; prevent or avoid abuse, neglect, and/or exploitation.
Eligibility: • Adults 18 or over • Functional disability
• Assets less than $20K, +$3000 for each additional family member
• Other financial resources reviewed to determine level of need
Case Management Services: • Comprehensive Assessment of needs
and functioning • Information and Referral • Voluntary program
• Crisis Intervention • Coordination and monitoring of
Services received from community and government programs
Waitlist • Referrals for SSTA Assessment are triaged and placed on a Waitlist prior to
assessment (Current SSTA Waiting List 298). • Referrals come from 7-3000, eICM Referral, and from APS investigations directly 36
SENIOR CARE
Statewide service program providing eligible seniors with gapfilling funds to purchase products and services necessary to help them remain in their homes or the least restrictive placement in the community.
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• Emergency Response System • Medical Supplies and Equipment • Others: Glasses, Dental Emergency, • 20% Co-Pay for Medicare
ELIGIBILITY CRITERIA • Age: 65 and over • Disability: Moderate or Severe • Residence: within Montgomery County • Risk of institutionalization or more
restrictive placement
less, Assets: $11,000 or less Couple Annual: $44,580 or less,
Assets: $14,000 or less
WAITLIST: • Maintained due to high demand for gap-filling funds • Applicants scored based on level of need and length of time on Waitlist
FY19 Budget: $4.4 million
In FY18, Home Care served a total of 279 clients
77% frail seniors
23% adults with disabilities
Client Profile: low income, moderate to severely disabled adult, who lives alone and is isolated, with minimal family/caretaker assistance
Average vendor cost per client who receives personal care annually is $10,348
Approximately 269 clients who receive personal care are served monthly
Clients receive an average of 8-9 hours of personal care services weekly. (Statewide average is 6 to 8 hours weekly)
Waiting List information:
the Home Care personal care waiting list averaged 59 clients monthly
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An individual is eligible for In-Home Aide Service (IHAS), if the individual (has a need for the service based on an ADL [Activities of Daily Living] score and a prioritized ranking triage score) and: is receiving case management services; is unable to secure the service from another resource - Medicare Private insurance Family Community First Choice (MDH) Other Community Resources;
is willing to accept the service; and agrees to pay an assessed fee.
COMAR 07.06.12.03
COMMUNITY RESIDENTIAL SERVICES/ADULT FOSTER CARE
Purpose Community Residential Services, Adult Foster Care Program (AFC) provides ADL care to adults with disabilities, and frail elders, in family homes or in Assisted Living Homes, as a lesser restrictive alternative to nursing homes. AFC/PH Eligibility 1. 18 years or older, Montgomery County resident
2. Typical referrals are via APS
3. Requires supportive housing which includes ADL care, room and board, and protective oversight, due to a disability which renders the individuals unable to live independently.
4. Does not require services beyond capacity of the AFC program.
5. AFC providers typically cannot meet the following needs:
-Volatile behavior patterns
-Awake overnight supervision
6. Applicant agrees to pay toward the cost of AFC placement from personal income and resources.
7. County funds must be the fund of last resort
-Verification of income and assets must be provided.
-Applicant must apply for all benefits for which they are eligible such as Social Security, Medical Assistance, Medicare, Medicare D, Public Assistance to Adults (PAA), Metro Access, CFC Waivers.
-Applicant or current client in placement must apply for and accept appropriate supportive housing available in the Public Mental Health system or The Developmental Disabilities Administration. 40
The “Balancing Act”
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AAAs were established under the Older Americans Act (OAA) in 1973 to respond to the needs of Americans 60 and over in every local community.
Provide a range of options that allow older adults to choose the home and community-based services and living arrangements that suit them best.
The OAA is expected to be reauthorized by Congress in 2019.
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Area Agency on Aging (AAA)
The Commission on Aging (CoA) was established in 1974, and has operated under the County Executive since 1987.
The CoA was created to: Improve conditions of the aging or elderly in the County Work toward the elimination of restrictions that impede older citizens from full
participation in the mainstream of community life; and Assist and stimulate all levels of governments and the community to be more
responsive to the needs of the County’s older residents Also serves as the advisory council to the Area Agency on Aging as required by
the Older Americans Act
The CoA operates with several committees, 28 commissioners serves on the CoA.
All activities of the CoA are open to the public. The CoA meets monthly except during the summer when they conduct
summer studies. CoA has a webpage and a Facebook page.
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48.00%
37.00%
6.00%
9.00%
Funds
Aging and Disability Resource Unit (ADRU)
Adult Evaluation and Review Services (AERS)
Senior Nutrition Program
Supports Planning Agency
Caregiver Supports Program 45
Caregiver Supports Program
Adventist Healthcare + Holy Cross Health – Self-Management of Diabetes Workshops and other chronic diseases
Jewish Council for the Aging – Employment programs for older people (SCSEP, Employment Expo, and Career Gateway); Interages and related programs (a volunteer tutoring program); Escorted Transportation; SHIP
Legal Aid Bureau – Legal services for older people
Every Mind - Friendly Visitor Program; Representative Payee
Senior Connection – Transportation and Grocery Shopping Service
Mobile Dentist – Basic dental services and dentures
Respite Services of Montgomery County – Respite care
Nurse Monitoring – Potomac, Advanced, Visiting Angels, Specialty, Candid 47
Area Agency on Aging Contracted Service
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Assisted living services
Medical day care
Dietician/ nutritionist services
Home delivered meals
Pharmacy services
Medicare co-payments and deductibles paid
DAILY LIVING SUPPORTS
live safely at home or in an assisted living
setting
Community Services for Adults and People with Disabilities provides select services that are essential for eligible participants to remain healthy and well-cared for outside a skilled-nursing facility.
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Individuals with Community Mediciad can call and initiate the process to
confirm eligibility and receive services through the Community Personal
Assistance Services and Community First Choice programs. Individuals
seeking the Community Options Waiver level of services would need to
apply in one of two ways: 1. After having Long-Term Care Medicaid in a nursing facility for 30 days- apply for the
Community Options Waiver program and seek a transition back into the community. 2. Receive an application from the State based after being selected from the Waiver
Registry. There are ~23,000 names on the registry and the State is now sending out Waiver applications to 300 people/month from the registry based upon date of entry.
Potential participants can add their names to the CFC Registry (CO Waiver
only) by calling 1-844-627-5465 (toll-free) or 1-240-777-3000 for a Level One
Screen. Residents with Community Medicaid can call the numbers and
initiate the request for services right away (at the CPAS or CFC level).
Availability is limited in the CFC program, and there are only two ways of accessing services.
Age-Friendly Montgomery A community that is designed to meet the changing needs of all County residents, with
a focus on our rapidly growing and diverse older population.
Recognized as an age-friendly community in 2015 by World Health Organization (WHO) and AARP.
Ten work-groups devised to match up with WHO/AARP Domains with members from government, non-profits, and businesses
Civic and Social Involvement
Senior Public Safety
Montgomery County was recognized a Dementia Friendly community in 2015
Dementia Friendly America, “is a multi-sector collaborative on a mission to foster ‘dementia friendly’ communities
Montgomery County HHS has partnered with BrightFocus Foundation and the County’s public safety team to support caregivers and their families
Developed a speaker’s bureau to reach out to businesses in the County.
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Facilities Medical Care Income Support
Services Home Modification
o My Turn o Autism Waiver o Coordination of Community
Services o Support to Developmental
Disabilities Providers o Respite Services o Contracts and Outreach Services o Customized Employment
CSN FY19 budget by program
TOTAL CSN BUDGET: $23,534,684
CSN Admin (all personnel)…
Emergency & Critical Support Services…
Total CSN clients: 829
My Turn Eldora Taylor, Program Manager , x7-1173
o My Turn - supports families with children (ages 3 to 13) who have a developmental disability
o The goal is to link the family and the child to available resources that will establish a circle of community supports
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My Turn Program Eligibility
o They must reside in Montgomery County and meet the following eligibility criteria: o Children must have a diagnosed developmental disability
as defined by the State of Maryland Developmental Disabilities Administration.
o A severe chronic disability that is attributed to a physical or mental impairment other than the sole diagnosis of mental illness or a combination of mental and physical impairments.
o The disability is likely to continue indefinitely and results in an inability to live without external supports.
o Must provide current IEP and psychological
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My Turn How to Access?
o Any family residing in Montgomery County who is caring for a child diagnosed with a developmental disability (that is not receiving long term funding through any county or State programs) may call for an intake interview.
o Referrals can be made to the program from school personnel or professionals in the community currently working with the children.
Montgomery County Department of Health and Human Services
Community Support Network 240-777-1216
Autism Waiver Program Karen Gipson, Program Manager, x7-4266
o Service Coordination is provided via a contract with Montgomery County Public Schools to provide case management services for children approved and enrolled in the Autism Waiver Program
o In order to obtain Service Coordination, the child must be approved through MDH/MSDE
o Links enrolled children up to age 21 and their families to services
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o Must be determined “technically” eligible
o Financial Eligibility – based on the child’s income and resources. MDH determines financial eligibility
o Medical Eligibility – by a licensed Psychologist or Certified School Psychologist
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Presenter
Presentation Notes
Technical – including beting diagnosed with ASD, have an IEP and meet an institutional level of care and can be served in the community with waiver services. Once on the waiver must use at least 1 waiver services per month
Autism Waiver Program How to Access?
o There is a waiting list to access the Autism Waiver. Many children are on the AW registry (waiting list) for years before a space becomes available.
o No assessment done before children are placed on the waiting list.
o Montgomery County’s AW Program is currently serving 266 children.
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Coordination of Community Services Rosemary DiPietro, Program Manager, x7-4589
o Provide case management for persons on the Waiting List for services as well as for persons receiving services funded by the Developmental Disabilities Administration (DDA)
o Coordination of Community Services (CCS) Program assists individuals with intellectual/developmental disabilities and their families in learning and gaining access to resources in their community, planning for their future, and accessing needed services and supports
o Role of CCS has changed in recent years because of DDA’s Transformation Plan including the transition to Person Centered Plans
o MCDHHS’ CCS Program has a client cap of 500 clients
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Maryland State Law [Health General ‘ 7-101(e)] defines developmental disability as a severe chronic disability that:
o is attributable to a physical or mental impairment, other than the sole diagnosis of mental illness, or to a combination of mental and physical impairments;
o is manifested before the individual attains the age of 22;
o is likely to continue indefinitely; o results in the inability to live independently without
external support or continuing and regular assistance; and
o reflects the need for a combination and sequence of special, interdisciplinary, or generic care, treatment, or other services that are planned and coordinated for that individual.
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o Contact DDA’s Southern Maryland Regional Office at 301-362-5100
o Complete written application
o Personal interview and secure documentation of disability from applicant
o Prepare & submit report to the DDA Regional Office
DDA makes the determination of eligibility
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Coordination of Community Services Service Categories
The CCS program provides case management services to the following client categories:
• Waiting List
• Crisis Resolution
• Crisis Prevention
• Current Request
• Ongoing Services
Coordination of Community Services Transitioning Youth
DDA-funded services are not an entitlement. Funding for TY services comes, in part, from one of DDA's three federal waiver programs: Community Pathways, Family Supports, or Community Supports. Waivers allow the DDA to provide specific services through funding from the federal Centers for Medicare and Medicaid Services (CMS). Transitioning Youth comprise a special category of eligibility and priority for services
Additionally, the Governor's Transitioning Youth Initiative (GTYI) earmarks funds in the DDA budget for eligible students leaving school. This initiative, in collaboration with the Division of Rehabilitative Services (DORS), has been able to fund supported employment and other day services for eligible graduating students who otherwise may not have received DDA services.
CCS staff assist families as they transition from the school system into the adult system. The age of transition begins at 14 and ends at 21.
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Family Supports Waiver
Provides individual and family supports for children birth to 21 with developmental disabilities that are on the DDA Waiting List. The waiver is capped at 400 individuals with a budget cap of $12,000 annually
Community Supports Waiver
Provides supports for individuals of all ages with developmental disabilities that are on the DDA Waiting List. The waiver is capped at 400 individuals with a budget cap of $25,000 annually.
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Respite Services
o Respite services are currently provided via a contract with the Arc Montgomery County
o Provides temporary relief and support for the primary unpaid caregiver who provides ongoing care to frail elderly persons, children and adults with disabilities, and/or children with severe medial or behavioral needs.
o If you have clients in need of respite – call 301-816-9647 to begin the application process.
o Once the application is completed and returned, the staff work with the families to locate the most appropriate provider. Financial subsidies are available on a sliding scale.
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Respite Services New Policy Changes (effective July 2018)
Current Respite Clients that are receiving in-home supports via state funded programs - Keep the hourly cap the same for them but end services mid -year:
Those receiving more than 40 hours/week of support will have access to 48 hours until December 31, 2018 and will no longer be eligible for county respite services.
Those receiving 40 hours or less of support/week will have access to 140 hours for until December 31, 2018 and will no longer be eligible for county respite services.
In addition, no new in-home state paid programs (Autism Waiver, Community First Choice, REM, Community Pathways/New Directions, Family Supports Waiver, Maryland Community Supports, etc.) are eligible to apply for county respite services effective July 1, 2018.
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Financial Assistance to DD Providers Eldora Taylor, Program Manager, x7-1173
The County provides financial assistance to 32 DDA licensed providers who support residents with developmental disabilities in the following services:
o Day/Supported Employment
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o Transportation
o After school care and camps
o Community Inclusion/advocacy
o Group Home Site Visits
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o An initiative to create flexible work opportunities for individuals with significant disabilities to fulfill work requirements of County Departments.
o Utilizes customized employment techniques to create a true match between the department’s needs and the interests of the job candidate with the disability
o Positions are part time and temporary (anywhere between 2-18 hours/week - not to exceed 900 hours within 2 years of work)
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Presenter
Presentation Notes
Goal is that interns will gain job experience and training and be able to compete for merit positions in the County and other places of employment.
Work Group on Meeting the Needs of Residents with Developmental Disabilities
Council requested the creation of this group in Resolution #18-989.
Workgroup met throughout the summer and early fall to discuss issues and develop recommendations
Resulted in a report that includes system wide recommendations and white papers on several topics including Coordination of Community Services, Employment, Housing, and Recreation
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By 2040, nearly 60% of 55+ adults will be part of a minority group
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NATIONAL DATA
SELF-NEGLECT:is the inability of a vulnerable adult to provide for his/her physical or mental health and well-being;
Exploitation:any action which involves the misuse of a vulnerable adult’s funds, property or person
NEGLECT:Is the willful deprivation of a vulnerable adult from adequate food, clothing, medical treatment, shelter, or supervision
ABUSE:Sustaining of any physical injury by a vulnerable adult as a result of cruel or inhumane treatment or as a result of a malicious act by a person
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WHAT APS CANNOT DO
The “Balancing Act”
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CSN FY19 budget by programTOTAL CSN BUDGET: $23,534,684
CSN Client breakdown by program as of September 2018Total CSN clients: 829
My TurnEldora Taylor, Program Manager , x7-1173
My TurnProgram Eligibility
Autism Waiver ProgramKaren Gipson, Program Manager, x7-4266
Autism Waiver ProgramProgram Eligibility
Autism Waiver ProgramHow to Access?
Coordination of Community ServicesRosemary DiPietro, Program Manager, x7-4589
Coordination of Community ServicesEligibility
Coordination of Community ServicesHow to access?
Coordination of Community ServicesService Categories
Coordination of Community ServicesTransitioning Youth
Coordination of Community ServicesNew DDA Waivers
Respite Services
Financial Assistance to DD ProvidersEldora Taylor, Program Manager, x7-1173
Contracts and Outreach Services
Customized Employment Public Intern Project
Work Group on Meeting the Needs of Residents with Developmental Disabilities
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